急性缺血性脑卒中患者CT脑灌注的针对性护理

Targeted Nursing of CT Cerebral Perfusion in Patients with Acute Ischemic Stroke

目的探讨在对急性缺血性脑卒中(acute ischemic strok,AIS)患者采用双源CT行脑灌注(CT Perfusion imaging,CTP)扫描过程中的护理技术,从而为及时准确诊断患者提供支持。方法采用随机数表法随机选取2014年8月—2017年12月日照市人民医院CT脑灌注的AIS患者54例为A组(常规护理),2018年1—12月并采用相同机器脑灌注AIS患者54例为B组(针对性护理),2014年8月—2017年12月在相同机器脑灌注的慢性脑血管狭窄患者54例为C组(常规护理)。分别对比3组患者一般资料、图像质量、护理满意度进行评分和不良反应及造影剂渗漏发生率。结果①3组患者一般资料比较差异无统计学意义(P>0.05)。②图像质量评价:客观图像质量评价中A组CNR(23.38±7.87)、B组(28.91±6.43)、C组(29.88±3.21),A、B及A、C两组对比,差异有统计学意义(P<0.05),B、C两组对比,差异无统计学意义(P>0.05)。主观图像质量评价中2名医师的一致性较好(A组Kappa值=0.517,B组Kappa值=0.500,P=0.000);A组(3.11±1.15)、B组(3.93±0.85)、C组(4.20±0.33),A、B及A、C两组对比,差异有统计学意义(P<0.05),B、C两组对比,差异无统计学意义(P>0.05)。③护理满意度:A组,满意23例(42.6%)、一般(38.9%)、不满意(18.5%);B组,满意(70.4%)、一般(29.6%)、不满意(0.0%);C组,满意(50.0%)、一般(37.0%)、不满意(13.0%)。B组和A、C组分别在满意和不满意两项评分上差异有统计学意义(P<0.05)④不良反应和造影剂渗漏发生率,不良反应A、B、C组分别为3、2、2例,渗漏数分别为3、2、1例。结论针对AIS患者开展针对性的全程精细化护理有助于提高图像质量及护理满意度。

Objective To explore the nursing techniques in patients with acute ischemic stroke(AIS)who underwent dual-source CT perfusion imaging(CTP)scanning to provide timely and accurate diagnosis.Methods Using random number table method,54 cases of AIS patients with CT cerebral perfusion of Rizhao People's Hospital from August 2014 to December 2017 were selected as group A(conventional nursing),and the same machine brain perfusion AIS was used from January to December 2018.54 patients in group B(targeted care),54 patients with chronic cerebrovascular stenosis in the same machine brain perfusion from August 2014 to December 2017 were group C(conventional care).The general data,image quality,and nursing satisfaction scores and adverse reactions and the incidence of contrast leakage were compared between the three groups.Results 1.General information,the general data of the three groups of patients were not significantly different(P>0.05).2.Image quality evaluation,objective image quality evaluation in group A CNR(23.38±7.87),group B(28.91±6.43),group C(29.88±3.21),A,B and A,C group,the difference between the two groups was statistically significant(P<0.05),B,C group,there was no significant difference betweeh the two groups(P>0.05).The consistency of the two physicians in the subjective image quality evaluation was better(group A Kappa=0.517,group B Kappa=0.005,P=0.000);group A(3.11±1.15),group B(3.93±0.85),group C(4.20±0.33),A,B and A,C group,the difference the two groups was statistically significant(P<0.05),B,C group,there was no significant difference betweeh the two groups(P>0.05).3.Satisfaction of nursing:group A,satisfied 23(42.6%),general(38.9%),unsatisfied(18.5%);group B,satisfied(70.4%),general(29.6%),unsatisfied(0.0%);Group C,satisfactory(50.0%),general(37.0%),unsatisfactory(13.0%).There were differences in the scores of satisfaction and dissatisfaction between group B and group A and group C(P<0.05).4.adverse reactions and incidence of contrast agent leakage;Groups A,B and C were 3 and 2 respectively.In 2 cases,the number of leaks was 3,2,and 1,respectively.Conclusion Targeted,comprehensive,and refined care for AIS patients can help improve image quality and care satisfaction.